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Lawmakers doubt VA’s credibility, transparency on care plan

New initiative is bid to reduce wait times, but Congress skeptical

- The Washington Times - Monday, June 23, 2014

Lawmakers commended the VA on Monday for taking some actions to improve waiting times, but criticized the department for its lack of transparency about its new initiatives and wondered why it took so long to make seemingly-obvious fixes.

The VA says its Accelerating Access to Care Initiative allowed for 200,000 appointments to be scheduled in the last two weeks in May, taking a step to improve lengthy wait times faced by veterans. But Rep. Jeff Miller, Florida Republican and chairman of the House Veterans Affairs Committee, wondered how reliable that number is given the department's history of providing unreliable data.

"Data manipulation of patient waiting times was found to be widespread. Given that, how can Congress, the American taxpayer, and our nation's veterans and their families have any confidence in these latest numbers the Department has released?" Mr. Miller said at a Monday night hearing.

The Accelerating Access to Care Initiative launched May 23 as an effort to get veterans in for appointments in a timely manner. The program includes reviewing clinic capacities, extending clinic hours to nights and weekends, and letting providers collect overtime. It's expected to cost $312 million and is being funded by money recovered from across the VA, according to Dr. Thomas Lynch, assistant deputy undersecretary for health for clinical operations.

"While we realize that the timeliness of these services is in question, VA acknowledges and is committed to correcting unacceptable practices in patient scheduling," Dr. Lynch said. "This is a breach of trust. It is irresponsible and it is unacceptable."

Mr. Miller said he requested a briefing on the initiative on June 2, and followed up with a formal letter to VA Acting Secretary Sloan Gibson on June 5, but has yet to hear back as of Monday. He called the department's lack of cooperation just one instance in a "long and continually increasing list of examples of VA failing to act in an open and transparent manner."

"If VA's work has indeed led to 200,000 more appointments for veteran patients so far, what is there to hide?" he said.

He also questioned why it took so long to put these potentially life-saving changes in place.

"It is too late for those 35 Phoenix-area veterans and it may be too late for other veterans who have been waiting for weeks, months, and – in some cases – years," he said. "So I ask again, if there were actions that VA could have taking to increase access to care for veterans patients, why were those actions not taken long before now?"

Rep. Tim Walz, Minnesota Democrat, said that the department has lost its credibility in recent months as its interactions with Congress have lacked transparency and accurate numbers.

“I think the time has come when you know you don't get the benefit of the doubt any more,” he said.

Rep. Mike Coffman, Colorado Republican, said said the department needs to clean house and bring in new people to fix long-standing problems since Dr. Lynch does not seem angry enough about the poor-quality care at the VA.

“What we're asking is for the same people who drove us into this ditch to get us out of this ditch,” he said.

When Dr. Lynch said he thought the VA was still a good system that just faced challenges, Mr. Coffman raised his voice, yelling that it was “absolutely stunning” Dr. Lynch could still say that after everything that's been revealed over the past two months.

“Not if you're a veteran, it's not a good system,” Mr. Coffman said.

Mr. Miller also asked about a letter from the Justice Department's Office of Special Council sent earlier Monday that included reports of a veteran with service-connected mental health issues being held at a VA facility for eight years with only one medical note in his file. The letter said this type of patient neglect is not an isolated problem, and is a widespread issue that the VA is doing little to fix.

In response to the letter, Mr. Gibson ordered a review of the Office of the Medical Inspector to be completed in two weeks. Dr. Lynch said it's important to wait for the results of this review before drawing any conclusions.

"The Office of the Medical Inspector is unique in healthcare. We don't see it in the private sector. It is VA's arm to evaluate objectively outside of the facility concerns about the quality of care," he said. "VA and our acting secretary have taken those concerns very seriously. We need to take those seriously because VA is in a position where we have to reestablish our credibility."

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